Intensive care unit stays are linked to a doubling of dementia risk

Intensive care unit stays are linked to a doubling of dementia risk

Chicago, USA – Older people who have spent time in an intensive care unit (ICU) are twice as likely to develop dementia later in life than older people who have never been in an ICU, according to a news report study. The findings were presented at the Alzheimer’s Association International Conference (AAIC) 2022 [1].

“Hospitalization in an intensive care unit may be an unrecognized risk factor for dementia in older adults,” Medscape Medical News told Medscape Medical News. Bryan D. JamesPhD, epidemiologist at Rush Alzheimer’s Disease Center, Chicago, Illinois.

“Healthcare professionals caring for elderly patients who have been hospitalized with serious illness should be prepared to assess and monitor their patients’ cognitive status as part of their long-term care,” added Mr James.

A hidden risk factor?

The study showed that hospitalization in an intensive care unit following a serious illness is linked to later cognitive impairment in elderly patients (Alzheimer’s disease or other age-related dementias) . However, we do not know by what mechanisms.

“Given the high rate of intensive care hospitalizations among older adults, particularly during the Covid-19 pandemic, it is critical to explore this link,” said Bryan D. James.

Rush’s team assessed the impact of a stay in an intensive care unit on the risk of dementia in 3,822 older adults (average age 77 years) with no known dementia at baseline and participating in five diverse epidemiological cohorts.

Participants were screened annually for the development of Alzheimer’s disease and all types of dementia using standardized cognitive assessments.

Over an average of 7.8 years, 1991 (52%) adults have experienced at least one stay in an ICU; 1031 (27%) had experienced one in an ICU before study recruitment; and 961 (25%) experienced such an ICU stay during the study period.

In models adjusted for age, gender, education, and race, ICU hospitalization was associated with a 63% higher risk of Alzheimer’s dementia (hazard ratio [RR] 1.63; 95% CI, 1.41 – 1.88) and at a 71% higher risk of dementia of all types (RR, 1.71; 95% CI, 1.48 – 1.97).

In models adjusted for other factors such as risk factors and vascular disease, other chronic medical conditions, and functional disability, the association was even stronger: intensive care hospitalization was associated with increased risk approximately twice as high in Alzheimer’s dementia (HR 2.10; 95% CI, 1.66 – 2.65) and dementia of all types (HR, 2.20; 95% CI, 1.75 – 2.77).

James told Medscape Medical News it’s unclear why a stay in intensive care may increase the risk of dementia.

“This study was not designed to assess the causes of the higher risk of dementia in people who had been hospitalized in intensive care. However, the researchers looked at a number of factors that could explain this increased risk,” he explained.

One is the serious illness itself – which led to hospitalization – and which could lead to brain damage; for example, severe Covid-19 has been shown to directly damage the brain, said Bryan D. James.

He also noted that certain specific events that occur during the stay in the intensive care unit increase the risk of cognitive impairment, including infection and severe sepsis, acute dialysis, neurological dysfunction and delirium, as well as sedation.

Important work

Speaking about the study for Medscape Medical News, Heather SnyderPhD, vice president of medical and scientific relations for the Alzheimer’s Association, said the value of this study is that it looks at people placed in intensive care, regardless of the cause. .

“This is very important, especially considering the increase in the number of people, especially those aged 60 and over, who have been in an intensive care unit over the past two years.

“If a person has been in an intensive care unit, their doctor or healthcare provider should be informed,” Dr. Snyder advised.

The study was funded by the National Institute on Aging. Researchers Bryan D. James and Heather Snyder have disclosed no relevant financial relationship.

The article originally appeared on Medscape.fr under the title ICU Stays Linked to a Doubling of Dementia Risk. Translated and completed by Stéphanie Lavaud.

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